IMAGE OF THE MONTH: November 2022
Bombs Away: A Female Patient with Intermittent Photopsias
Introduction
32 year old healthy female patient presents with intermittent flashing lights in her left eye. Visual acuity is 20/20 OD and 20/20 OS.
DIAGNOSIS
Torpedo Maculopathy OS
Discussion
Torpedo maculopathy is typically described as a solitary, hypopigmented, oval-shaped lesion with a wedge-shaped tail extending along the horizontal raphe. The differential diagnosis of torpedo maculopathy includes chorioretinal scarring, prior trauma, CHRPE, Gardner Syndrome-associated congenital RPE hypertrophy, congenital RPE albinotic spots, RPE harmartoma, choroidal nevus, choroidal melanoma, and viteliform or pattern dystrophies. OCT (shown below) for this patient demonstrates features typical of Type 2 torpedo maculopathy characterized by loss of ellipsoid and interdigitation zones as well as thinning of the outer nuclear layer associated with outer retinal cavitation, with relative preservation of inner retinal layers. The patient was observed with stable BCVA and OCT findings for a total of 6 years from diagnosis to most recent clinic visit.
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